Drug Overdose Management · Pharmacology

Sodium Bicarbonate is used in Tricyclic Antidepressant (TCA) overdose primarily to:

  1. Alkalinize the urine to increase TCA excretion
  2. Neutralize the acidic TCA molecules in the stomach
  3. Narrow the QRS complex by raising serum sodium
  4. Induce vomiting to clear the drug
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Correct answer: Narrow the QRS complex by raising serum sodium

TCAs cause cardiotoxicity by blocking fast sodium channels. Sodium bicarbonate increases extracellular sodium and serum pH, which alleviates this blockade and reduces the risk of lethal arrhythmias.

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